An Innovative Design
The motivation for this research comes from the experience of Professor David Wheatley, a clinical and academic cardiac surgeon with decades of experience of heart valve disease in different parts of the world. His knowledge has culminated in a potential solution to the clinical problems associated with current prosthetic heart valves, particularly in the developing world.
The majority of heart valve disease presents in the developing world where rheumatic fever is still prevalent. Currently the mechanical valves available for surgical treatment of advanced irreparable valve disease require life-long anticoagulant or antiplatelet therapy to mitigate thromboembolic complications. Such therapy is often impractical or unavailable for those patients in the developing world. The alternative biological valves are less at risk of thromboembolic complications but have more limited durability, especially in young patients who are in the majority presenting with valve disease in developing countries.
The quest has been to design a prosthetic valve that would be sufficiently resistant to degradation in the body to offer the prospect of survival in excess of two decades or more, while at the same time not running an associated appreciable risk of thromboembolic complications attributable to abnormal flow conditions associated predominantly with mechanical valves.
The Wheatley design differs from the usual design of flexible-leaflet valves as it is intended to interact with known flow patterns within the ascending aorta. This interaction should facilitate leaflet opening and closing, as well as avoiding areas of abnormally high or low shear stress at the valve/blood interfaces and areas of poor washout of blood around the valve. The design is also intended to significantly reduce the stresses within the leaflet material that are inherent in the current designs modelled on the natural aortic valve. This is a further feature that offers the prospect of enhanced durability compared to many flexible-leaflet valves.
The valve frame has been carefully designed for easy manufacture and to securely support the three leaflets. Refinements in the frame design and the manufacture of the leaflets has taken years. Read more about the development history of the heart valve on our articles page.
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